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Presentation comparison
EmergencyCovers delirium, acute confusion, toxic-metabolic encephalopathy, and post-ictal confusion.
3 of 7 diagnoses compared
| CriteriaComparison detail | Substance intoxicationEmergency |
|---|
Inattention plus altered awareness/arousal are the key separators. Usually precipitated by acute illness, surgery, injury, retention, constipation, pain, or medicines.
Clinical reference — not validated decision support. Review before use.
| Post-ictal stateEmergency |
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| DeliriumEmergencyNot selected |
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| Dementia with superimposed deliriumEmergencyNot selected |
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| Wernicke encephalopathyEmergencyNot selected |
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| Hepatic encephalopathyEmergencyNot selected |
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| Why it fits | Time-link to use, toxidrome clues (pupils, RR, nystagmus, tremor) | Time course, tremor, sweats, tachycardia, hypertension, anxiety, seizures | Witnessed or suspected seizure, stereotyped event, post-event confusion | Acute change, fluctuating course, inattention | Known cognitive disorder with sudden worsening | Heavy alcohol use, malnutrition, triad of confusion/ataxia/eye signs may be incomplete | Liver disease, asterixis, GI bleed, constipation, infection |
|---|---|---|---|---|---|---|---|
| What argues against | Applies to the whole presentationPrimary psychosis, dementia | ||||||
| Must-not-miss | Opioid respiratory depression, head injury, hyperthermia | Alcohol/benzo withdrawal seizures, delirium tremens, severe GHB withdrawal | Non-convulsive status epilepticus, head injury | Sepsis, hypoxia, hypoglycaemia, stroke | |||
| Bedside question | Applies to the whole presentationInattention plus altered awareness/arousal are the key separators. Usually precipitated by acute illness, surgery, injury, retention, constipation, pain, or medicines. | ||||||
| Immediate action | Applies to the whole presentationDo vitals, BGL, sats, attention testing, collateral, and medication/substance review early Use 4AT in most adult settings, and ICU tools where appropriate | ||||||
| Investigations | Applies to the whole presentationBlood glucose, Vitals and oxygen saturation | ||||||
| Mimics / overlap | Applies to the whole presentationPrimary psychosis, dementia, severe depression, catatonia | ||||||
Scroll horizontally to review more candidate differentials. Clinical reference — not validated decision support. Review before use.
Primary psychosis, dementia
Inattention plus altered awareness/arousal are the key separators. Usually precipitated by acute illness, surgery, injury, retention, constipation, pain, or medicines.
Do vitals, BGL, sats, attention testing, collateral, and medication/substance review early Use 4AT in most adult settings, and ICU tools where appropriate
Blood glucose, Vitals and oxygen saturation
Primary psychosis, dementia, severe depression, catatonia
Time-link to use, toxidrome clues (pupils, RR, nystagmus, tremor)
Opioid respiratory depression, head injury, hyperthermia
Time course, tremor, sweats, tachycardia, hypertension, anxiety, seizures
Alcohol/benzo withdrawal seizures, delirium tremens
Witnessed or suspected seizure, stereotyped event, post-event confusion
Non-convulsive status epilepticus, head injury
Safety first. Act early.
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v10 | Local content only
Last updated: Pending review
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Create a concise comparison summary for documentation or handoff.
Source pending review
v10 | Local content only
Last updated: Pending review
| Infection, retention, constipation, dehydration, medication toxicity, pain |
| Permanent cognitive injury, Korsakoff syndrome |
| GI bleed, sepsis, over-sedation, impending coma |